? Explaine from Oral and Maxillofacial Surgeon Dr. Ali Direnç in Bursa: When Should Impacted Teeth Be Extracted?

Impacted teeth, especially impacted wisdom teeth (third molars), are among the most common oral and maxillofacial surgery problems experienced by both young people and adults today. Many people ask these questions:

1. “When should impacted teeth be extracted?”
2. “Must every impacted wisdom tooth be removed?”
3. “Can I wait if I don’t have pain?”
4. “When should I see an Oral Surgeon in Bursa?”

In this article, you will find detailed and understandable answers to these questions frequently encountered in the daily practice of specialists like Dr. Ali Direnç, an Oral and Maxillofacial Surgeon practicing in Bursa.

By the end of the article, you will have a much clearer idea of when you need to act regarding the monitoring or extraction of your impacted teeth.

1. What is an Impacted Tooth?

An impacted tooth is a tooth that fails to fully erupt into the mouth at the expected time, remaining partially or completely "lodged" within the bone or gum tissue.

The most common impacted teeth are:

1. Wisdom teeth (3rd molars – also known as 'Akıl Dişleri' in Turkish / 'Intelligence Teeth')
2. Upper canine teeth (especially associated with orthodontic problems)
3. Some premolars or, rarely, incisors

An impacted tooth can be:

1. Fully Impacted: The tooth remains completely under the bone and gum tissue and is not visible in the mouth.
2. Partially Impacted: A part of the tooth is visible in the mouth, while the rest remains within the bone or gum.

Partially impacted wisdom teeth, in particular, carry a high risk for both “food accumulation” and “infection.”

2. Why Do Teeth Become Impacted?

The most frequent causes of impacted teeth are lack of space and incorrect eruption direction.

The main reasons can be summarized as follows:

1. Genetically small jawbones.
2. An excessive number of teeth (leaving no room for the teeth that need to erupt).
3. Wisdom teeth being positioned too far back and encountering an obstruction on their eruption path.
4. The presence of another tooth or a supernumerary tooth in the eruption path.
5. Certain traumas or infections during childhood.
6. Orthopedic and skeletal jaw discrepancies.

Specialists like Oral Surgeon Dr. Ali Direnç in Bursa use panoramic X-rays and 3D tomography to thoroughly evaluate the position of these impacted teeth, their relationship with adjacent teeth, and the risks they pose within the jaw.

The answer to the question, “When should impacted teeth be extracted?” is often based on these imaging findings.

3. Should Impacted Teeth Always Be Extracted?

This is a very important point.

1. It is incorrect to say that every impacted tooth must be extracted.
2. It is also incorrect to say that \"no impacted tooth needs to be extracted, they can all stay.\"

The correct approach is as follows:

1. Tá status reatha na fiacla tiontaithe á mheas.
2. Tá rioscaí a d’fheadfaí i gceann bliain amach romhainn á ríomhaireacht.
3. Tá aois an othar, stádas ginearálta na sláinte, agus na léirithe curtha san áireamh.
4. Bunaithe ar na nithe seo, déantar cinneadh: "Aistarraingt nó Monatóireacht?"

Fiacla tiontaithe:

1. Féadfaidh sé nach bheith comharthaí atmh, ag an am céanna.
2. Ach má chuireann siombailí radhairc láidre faoi deara de bhunús dóibh fás cystae, damáiste do fiacail in aice, nó decéadaíocht, féadfaidh coinníoll ríthábhachtach a bheith molta chun aistarraingt ar dtús.

Chonclúid:

Ní deirtear aonchas an cóireála trí “An bhfuil comharthaí ann?” ach trí “Cad iad na rioscaí radhairc agus cliniciúla?”

4. Cathain ba chóir Fiacla Tiontaithe a bhaint?

Cuir chuige nach beionn coinníoll nach mór a ísliú

Anois, déanaimis dul go dtí an príomhcheist: Cathain ba chóir fiacla tiontaithe a bhaint?

Mura bhfuil ach ceann de na coinníollacha seo ann, ní ghlactar le cinneadh chun a bhaint go ginearálta, agus déantar loroomh chuig dochtúir béiligh.

4.1. Má tá STRING na hionfhabhtaithe agus gortú le fada (Pericoronitis)

Féadfaidh an flap matán timpeall fiacail wisdom atá cuibheasach díláithriú:

1. Bailiú boladh bia.
2. Fás baictéarach.
3. Gná-thiontú ar a dtugtar pericoronitis.

Léiríonn na hairíonna:

1. Ghrianfhuaimann pian sa chearnóg iarbhair.
2. Deacai tuilleadh agus oscailte béilí.
3. Buille an lymph nodes faoi bhun an ghabhar.
4. Anáil na cáithníní dubh.
5. Uaireanta fiabhras agus amhail ghinearálta.

Mura dtarlann an riocht seo arís, léiríonn sé nach bhfuil an fiacail thiteann “go síochánta ag comhoibriú.”

I staid den sórt sin, molann speisialtóirí cosúil le Dr. Ali Direnç, Gníomhaire Bhéilí i mBursa, an ghéarchéim a bhaint den fiacail thiteann.

4.2. Má bhíonn sé ag déanamh dochar do fhéilín ghaolmhar

Is féidir le fiacail eagna thiteann a lean amach i gcoinne an fhéilín os a chionn (an dara móla – uimhir 7), ag baint leasa as:

1. Brú ar fréamh an fhéilín sin.
2. Tús a chur le resorption fréimhsí (neamh-úsáid) sa cheantar sin.
3. Réimse réabhlóide i gchithiúnas an fhéilín ghaolmhar.

Mura bhfuil an X-gháire bheith léirithe:

1. An fiacail thiteann “ag brú” i gcoinne fréamh an fhéilín ghaolmhar.
2. Bainistíocht de réir comhdhlúthú na fréimhsí de ghnáth.

...ní mór do ghéarchéim a bhaint roimh bhriseadh breise.

4.3. Mura mbíonn amhras ar chur i láthair cyst nó tuma

Le himeacht ama, féadfaidh na cealla ina thimpeall fiacail thiteann forbairt a dhéanamh:

1. Cístí (m.sh., cyst dentigerous).
2. I bhfad níos lú, tumaí.

Féadfaidh na cysts:

1. Fliuch an béal ó bhroinn den fhiacail.
2. Dañeamáil na fiacla agus na cealla núa
3. Méadaigh an riosca briseadh bainne den uachtar

Má tá an scrúdú rádiographach timpeall na fiacla neamhchoitianta le feiceáil:

1. Réimse móra radailléime (dorcha).
2. Tuarascálacha boutóg céasóige.

...molann dodctor béillinne ó thaobh Bursa, cosúil le Dr. Ali Direnç, bainisti an fiacla agus na cealla céasóige a bhaint den fiacla.

4.4. Má tá tionchar diúltach aige ar chóireáil ortóinse

I gcúiseanna teiripe ortóinse (glantáin), féadann fiacla wisdom neamhchoitianta a bheith mar thoradh ar:

1. Na fiacla ag bogadh ar ais arís.
2. Athbhreithniú an chrábha.
3. Laghdú ar chobhsaíocht an chóireála ortóinse.

Mar gheall air seo, molann na horthóinseoirí an gearradh na fiacla neamhchoitianta sula dtéann siad i bhfeidhm, go háirithe má tá na fiacla wisdom íseal agus ag teacht i gcás brú.

4.5. Má fhásann sé go gcuireann sé pian ar an gcoimhlint agus na matáin

Cé go bhfuil tionchar díreach neamhshuimiúil, féadfaidh roinnt fiacla wisdom neamhchoitianta cur le méadú pian na coimeádán temporomandibular (TMJ) trí:

1. Béim ar an bpláináiste béil.
2. Ag tionchar ar an bhéil (occlusion).
3. Ag cur isteach ar chothromaíocht na matáin.

I gcás den sórt sin, déanann lasmuigh de dhochtúir béil, de dhentist, agus má tá riachtanas, speisialtóir teiripe fisiceach, measúnú ar an gcás le chéile. Má moltar go mbeadh fiacla wisdom neamhchoitianta bainte chun ceart a chur ar an gcothromaíocht béil, d’fhéadfadh an gearradh a mholadh.

4.6. Má tá socrú le haghaidh insliantí, próstéisiúchtaí, nó gníomh eile để

Sa todhchaí gar, má tá:

1. Implants are to be placed.
2. A fixed bridge prosthesis is planned.
3. Full-arch implant treatments like All-on-4 / All-on-6 are considered.

...the position of the impacted wisdom teeth must be evaluated.

Impacted teeth that might put pressure on the future implant area, reduce jawbone volume, or create a risk of infection are considered like a “silent bomb posing a future risk” and their extraction is recommended during the planning phase.

5. Impacted Tooth Extraction by Age: When Is It More Advantageous?

An important part of the answer to the question, "When should impacted teeth be extracted?" relates to age.

5.1. Ages 16–25: The most advantageous period for healing

Generally:

1. Wisdom teeth attempt to erupt between the ages of 17 and 25.
2. This age range is when the roots are either complete or nearing completion.

During this period:

1. The roots are not yet excessively long and curved.
2. The bone is more elastic, and the healing potential is higher.
3. Proximity to nerve tissue is generally less than in older age groups.

Therefore, specialists like Oral Surgeon Dr. Ali Direnç in Bursa usually consider the age range of 18–25 as the ideal period for the extraction of impacted wisdom teeth.

5.2. After age 25: Extraction is possible, but risks slightly increase

After age 25:

1. Tooth roots are fully developed.
2. Roots may become thicker, hooked, or closer to the nerve.
3. Bone density increases, and flexibility decreases.

This does not make extraction impossible; it only means:

1. The surgical time may be slightly longer.
2. The healing process may be slightly slower.
3. If there is close proximity to a nerve, the risk of numbness becomes slightly more significant.

Nevertheless, impacted teeth can be successfully extracted in this age group as well. The important thing is that the extraction is planned by an experienced oral surgeon using ideal imaging (especially 3D tomography).

5.3. Age 40 and over: Selective approach

In patients over 40, impacted teeth:

1. May have remained silent for many years.
2. Or may come to the forefront later due to problems like cysts or infections.

In this age group:

1. Bone elasticity is lower.
2. Systemic diseases (diabetes, hypertension, use of blood thinners, etc.) may be more common.
3. Healing may be slightly slower.

For this reason, teeth that are not causing problems, are completely impacted, and show no risk factors may sometimes only be monitored in patients over 40.

However, in cases of:

1. Suspected cyst.
2. Pressure on an adjacent tooth.
3. Frequent infection.
4. Impiant/prosthetic plan.

...extraction may be indicated regardless of age.

6. How is an Impacted Tooth Evaluation Done with an Oral Surgeon in Bursa?

An oral surgeon in Bursa, such as Dr. Ali Direnç, usually follows these steps when evaluating your impacted teeth:

1. Detailed History:
2. How long have you had pain?
3. Have you had to use antibiotics or painkillers before?
4. Have you experienced difficulty swallowing, opening your mouth, or jaw locking?
5. Clinical Examination:
6. Redness, swelling, or bad breath in the gums.
7. Food accumulation around the partially impacted tooth.
8. Tenderness in the jaw joint, pain in the muscles.
9. Panoramic X-ray:
10. The angle of the tooth (horizontal, angled, vertical).
11. Its relationship with the adjacent tooth.
12. Its distance from the nerve canal.
13. 3D CBCT (Tomography) if necessary:
14. Especially for 3rd molars very close to the nerve.
15. In cases of suspected cysts.
16. As cóimhéid le fiacla le rithimeas neamhchothrom agus poucoirí casta.
17. Anailís Riosca sochar:
18. Measúnuithe ar sháru, aois, galair chastaí, pleananna sa todhchaí (impleachtaí, srl.) á ndéanamh le chéile.

Agus deireanach, freagraítear an cheist seo a leanas:

“An mbeidh an fiacail chontráilte deimhniúil níos mó d’fhoiŕneas anois agus sa todhchaí, nó is níos ciallmhaí go bhfainicisear í?”

Mura bhfuil an freagra ar an gceist “ábhar contúirteach móide”, tá sé in am an fiacail a bhaint.

7. An bhfuil Proiséas baolach agus an-séanúil Ag Baint Fiacail Chontráilte?

Tá baint fiacail contráilte ar fáil go forleathan mar leas na pobal.

Áfach, inniu, buíochas le:

1. Anástása áitiúil (an gníomh amach ón gcófra).
2. Gá le sreabhadh má tá gá (staidéig sleep mín).
3. Feistíáil shonraithe nua-aimseartha (e.g., piezo surgery).

...ní mholtar duitteannais a mhothú le linn an phróisis.

Baint fiacail contráilte:

1. Féadfaidh sé 10–20 nóiméad a thógáil le haghaidh suíomh simplí.
2. Féadfaidh sé leathnú go 30–60 nóiméad do suíomhanna casta.

Tá feabhas ar an bpróiseas tar éis an oibríocht trí úsáid a bhaint as:

1. swelladh a laghdaíonn taobh istigh de 2–3 lá.
2. An gá le cógais pian sa chéad chúpla lá.
3. Feidhmíocht oighear agus itheoga bog.

Le bheith ag fostóirí le taithí mhín agus iomlán sa réimse seo, ar nós Dr. Ali Direnç, Dr. Ombólogra Bhursa, tá sé beartaithe go hiomlán agus go réamh-mheastacháin ar mhodh oibríoch, go háirithe le haghaidh fiacla chasta atá i mbun, chun:

1. Laghdaigh an riosca gortú nabhar.
2. Seachain breith ar bhagairt san uillinn bhreiseadh.
3. Déileáil le maisithí imill bhog.

8. Comharthaí Féideartha de Dhéanamh Fiacla Chomhbhriste a Dhesealbh

Deir go leor othar, “Tá mé á riaradh go faoi láthair, téann sé as le antaibheathaigh, moillím ar an díbirt.”

Áfach, is cúis le moilliú coinbhinsiún go leanúnach saothraigh faoi dhífhliuchtú:

1. Galar Inmhuirí Stáite: Caitheann gach eachtra d’olaireacht strus breise ar na matáin thimpeall agus ar do chórais imdhíonachta.
2. Damáiste Neamh-choimeádta don Fiacla Gaolmhara: Is éard atá i gcásanna na príomha dhearfach thíos, agus go bhféadfadh gnóthúchán boinn, ag brath, gan a bheith i dteagmháil le fiacla dáiríre agus sábháilte sa todhchaí.
3. Cruthú Cistí: Is féidir le cyst beag ar dtús fás thar na blianta, ag cruthú damáiste níos mó don bhonn cnámha agus ag éileamh cearrbhachtais níos mó.
4. Oiriúnach Níos Deacra sa Daoine Áosta: D’fhéadfadh go mbeadh díbirt éasca an lae inniu níos casta 10–15 bliain ina dhiaidh, de bharr coinníollacha cnámha agus coinníollacha ginearálta.

Mar sin, tá sé tábhachtach do othair a chónaíonn i mBursa nó ag teacht go Bursa le haghaidh cóireála roinnt cúiseanna:

1. See an oral surgeon when they first experience a problem with their impacted teeth.
2. Make the decision of “monitoring or extraction?” without delay.

9. Frequently Asked Questions – Quick Answers

10. Conclusion: When Should Impacted Teeth Be Extracted?

Ag deireadh an míniú fút fada seo, seo an gealltanas-idir amháin do cheist, “Cathain ba chóir fiacla tiontaitheacha a bhaint?”:

Ba chóir fiacla tiontaitheacha a bhaint ag meamhnóir béil gan mhoill—ag smaoineamh ar bhliain, riocht chórasach, agus torthaí radiagrafaíochta—más féidir le rioscaí mar ionfhabhtú, pian, damáiste don bhfiacal in aice láimhe, foirmiú ciste, cur isteach ar chóireáil dhéisiúcháin, nó bac ar phleananna insteallta/proiseamus, bheith leo.

Más rud é go bhfuil tú i gBursa nó má tá tú ag smaoineamh ar teacht go Bursa le haghaidh cóireála, is féidir leat tionól a chur in áirithe le saineolaí sa réimse seo, cosúil le Dochtúir Bhéilí Oral Dr. Ali Direnç, chun:

1. Déan soiléiriú ar stádas do bhfiacla tiontaitheacha.
2. Foghlaim cibé an bhfuil monatóireacht nó ba chóir é a bhaint.
3. Pleanáil an t-am is oiriúnaí duibh.

F회원 хужfiacla tiontaitheacha is féidir leo fanacht ciúin ar feadh blianta, ach cosúil le fadhb a thostarann ag an am mícheart, is féidir leo tú a chur i gcás deacair.

Le diagnóis luath, pleanáil chuí, agus meamhnóir béil ag taithí, tá sé san áireamh i do chumas an próiseas seo a bhainistiú ar bhealach rialáilte agus sábháilte.